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NPI Code Detail

MEDICARE: TERESA JONES OLSON MD

MEDICARE: TERESA JONES OLSON MD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207Q00000XFamily Medicine Physician22983AL
2207Q00000XFamily Medicine Physician17349SC

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1619953015
Entity Type Code : Individual
Provider Name (Legal Business Name) : TERESA JONES OLSON MD
Provider Business Mailing Address
First Line : 300 E MCBEE AVE FL 4
Second Line :
City : GREENVILLE
State : SC
Zip : 29601-2842
Country : US
Telephone Number : 864-522-8603
Fax Number :
Provider Business Practice Location Address
First Line : 1316 N LAKE DR
Second Line :
City : LEXINGTON
State : SC
Zip : 29072-7653
Country : US
Telephone Number : 803-358-1191
Fax Number : 803-358-1180
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/16/2005
Last Update Date : 05/24/2023

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Directions to “ TERESA JONES OLSON MD” Practice Location

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